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Human Chorionic Gonadotropin

Common Name(s): HCG, Simeons diet, Simeons therapy

Clinical Overview

Use

Existing evidence does not support the use of human chorionic gonadotropin (hCG) in weight reduction, and the use of hCG for this purpose is not supported by the American Medical Association (AMA) or the American Society of Bariatric Physicians. Homeopathic preparations of hCG do not contain significant amount of the active ingredient, and clinical trials have not been conducted to provide evidence for effect. hCG is a one of the most common ancillary substances used by anabolic-androgenic steroid (AAS) users to not only enhance muscle/strength during stacking but to also reduce depressive symptoms upon AAS withdrawal.

Dosing

Recommendations for dosing for indications other than those approved for hCG cannot be made because evidence to support efficacy is lacking.

Contraindications

Precocious puberty, prostatic carcinoma or other androgen-dependent neoplasia, prior allergic reaction to chorionic gonadotropin, and pregnancy.

Pregnancy/Lactation

hCG is contraindicated in pregnant women. Avoid use in lactation.

Interactions

None well documented.

Adverse Reactions

Arterial thromboembolism, headache, irritability and other CNS symptoms, genitourinary effects, and hypersensitivity have been reported.

Toxicology

Defects of forelimbs and the CNS, as well as alterations in sex ratio, have been reported in mice on combined gonadotropin and hCG regimens. No mutagenic effect has been clearly established in humans.

Source

hCG is prepared from the urine of pregnant women. It can also be produced via recombinant DNA/genetic modification techniques.hCG 2005

History

In the 1950s, the endocrinologist Dr. Albert Simeons promoted the use of hCG together with an ultra-low calorie diet (500 calories per day) as a weight loss strategy in which the body would preferentially burn stored fat from the stomach, hips, and thighs without causing undesirable loss of muscle tissue, hunger, or irritability.

Following the publication of trials refuting its efficacy and including adverse events, the use of hCG fell out of favor. In 1995 the US Food and Drug Administration required labeling and advertising of hCG to state that there was no evidence of efficacy in weight reduction. Homeopathic drops and lozenges containing the "energetic imprint" of hCG have been promoted via the Internet.Robb-Nicholson 2010, Hamilton 2004

Chemistry

hCG is a water soluble glycoprotein hormone derived from the urine of pregnant women. It is produced by the developing embryo after conception and later by the placenta.hCG 2005

Uses and Pharmacology

The action of hCG is virtually identical to that of pituitary luteinizing hormone, although hCG appears to have a small degree of follicle-stimulating hormone activity as well. It stimulates production of gonadal steroid hormones by stimulating the testis to produce androgens and the corpus luteum of the ovary to produce progesterone.hCG 2005 Approved indications for the use of hCG are prepubertal cryptorchidism, hypogonadism, and ovulation induction. However, hCG is commonly used as an ancillary substance by AAS users for its anabolic effects and for managing AAS withdrawal symptoms.Sagoe 2015

Anabolic steroid use

hCG has been identified in a systematic review as one of the 10 most common ancillary substances used by AAS users. Across a total of 17 studies (ie, interviews, questionnaires, cases) that included 1,258 AAS users, hCG was often used to supplement "stacking" during AAS "on cycles" in order to improve testosterone production and enhance muscle/strength as well as prevent weight loss and testicular atrophy. Upon AAS cessation, hCG was used to minimize withdrawal symptoms such as depressive symptoms. Users included legal offenders, male and female weightlifters/bodybuilders, IV drug users, and footballers across a variety of settings (ie, police stations, gymnasiums, syringe exchange centers, online forums, prison, supplement shops, sports shops and associations).Sagoe 2015

In vitro fertilization

Adjunctive use of low-dose hCG (200 units/day) to a gonadotropin releasing hormone antagonist protocol in women undergoing in vitro fertilization/intracytoplasmic sperm injection, failed to produce any significant difference in rates of pregnancy, fertilization, implantation, or ongoing pregnancy in a randomized controlled trial (n=137).Aghahosseini 2014

Obesity/weight loss

hCG has not been demonstrated to be effective adjunctive therapy in the treatment of obesity, and it is the position of the American Society of Bariatric Physicians that hCG cannot be recommended for weight loss.4

Animal data

Animal studies are lacking for the use of hCG in obesity, and based on evidence from clinical trials, would now be redundant.

Clinical data

A meta-analysis of clinical trials conducted up to 1995 found no evidence of effect for hCG in weight loss, redistribution of fat, or sense of hunger or well-being, beyond that resulting from caloric restriction.Lijesen 1995 There have been no published quality clinical trials since the meta-analysis, and no clinical trials have been published using either homeopathic drops or lozenges.Hamilton 2004

Dosing

Recommendations for dosing for indications other than those approved for hCG cannot be made as evidence to support efficacy is lacking. Trials used 125 units of hCG daily for 6 days out of 7 over a 6-week period for weight reduction.Lijesen 1995, Young 1976

Homeopathic forms of hCG do not contain sufficient quantities of the active ingredient, and the efficacy of the "energetic imprint" has not been substantiated.ASBP 2009

Bioavailability of the injection is greater with intravenous delivery than with subcutaneous delivery.Chan 2003

Pregnancy / Lactation

Category X. hCG is contraindicated in pregnant women.hCG 2005

It is not known whether chorionic gonadotropin is excreted in human milk.hCG 2005

Interactions

hCG can crossreact in the radioimmunoassay of gonadotropins.hCG 2005

Adverse Reactions

Known adverse reactions include arterial thromboembolism, CNS symptoms (eg, headache, irritability, restlessness, depression, fatigue, aggressive behavior), and genitourinary and hypersensitivity effects, as well as local effects from the injection (eg, pain, edema).hCG 2005

The transmission of hepatitis that was historically associated with the use of jet injectors in clinics was resolved by use of single-use disposable syringes.Canter 1990, MMWR 1986

Toxicology

Defects of forelimbs and the CNS, as well as alterations in sex ratio, have been reported in mice on combined gonadotropin and hCG regimens. The dose of gonadotropins used was intended to induce superovulation. No mutagenic effect has been clearly established in humans.hCG 2005

References

Aghahosseini M, Aleyasin A, Yekehtaz H, Kashani L. Low-dose human chorionic gonadotropin adjunct to an antagonist protocol in assisted reproductive technology: a randomized trial study. Acta Med Iran. 2014;52(6):430-437.25130149
American College of Bariatric Physicians. Position Statement: Use of HCG in the Treatment of Obesity. http://www.asbp.org/resources/uploads/files/HCG%20Position%20Statement.pdf. Approved December 2009. Accessed May 11, 2011.
Canter J, Mackey K, Good LS, et al. An outbreak of hepatitis B associated with jet injections in a weight reduction clinic. Arch Intern Med. 1990;150(9):1923-1927.2393323
Chan CC, Ng EH, Chan MM, et al. Bioavailability of hCG after intramuscular or subcutaneous injection in obese and non-obese women. Hum Reprod. 2003;18(11):2294-2297.14585876
Hamilton M, Greenway F. Evaluating commercial weight loss programmes: an evolution in outcomes research. Obes Rev. 2004;5(4):217-232.15458396
Human Chorionic Gonadotrophin. Drug Facts & Comparisons. Facts & Comparisons [database online]. St. Louis, MO: Wolters Kluwer Health Inc; 2005.
Leads from the MMWR. Hepatitis B associated with jet gun injection—California. JAMA. 1986;256(4):446-447.3723733
Lijesen GK, Theeuwen I, Assendelft WJ, Van Der Wal G. The effect of human chorionic gonadotrophin (HCG) in the treatment of obesity by means of the Simeons therapy: a criteria-based meta-analysis. Br J Clin Pharmacol. 1995;40(3):237-243.8527285
Robb-Nicholson C. By the way, doctor. I've been trying to lose weight for a long time and nothing seems to work. What do you know about the HCG diet? Harv Womens Health Watch. 2010;17(9):8.20593560
Sagoe D, McVeigh J, Bjørnebekk A, Essilfie MS, Andreassen CS, Pallesen S. Polypharmacy among anabolic-androgenic steroid users: a descriptive metasynthesis. Subst Abuse Treat Prev Policy. 2015;10:12.25888931
Young RL, Fuchs RJ, Woltjen MJ. Chorionic gonadotrophin in weight control. A double-blind crossover study. JAMA. 1976;236(22):2495-2497.792477

Disclaimer

This information relates to an herbal, vitamin, mineral or other dietary supplement. This product has not been reviewed by the FDA to determine whether it is safe or effective and is not subject to the quality standards and safety information collection standards that are applicable to most prescription drugs. This information should not be used to decide whether or not to take this product. This information does not endorse this product as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about this product. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to this product. This information is not specific medical advice and does not replace information you receive from your health care provider. You should talk with your health care provider for complete information about the risks and benefits of using this product.

This product may adversely interact with certain health and medical conditions, other prescription and over-the-counter drugs, foods, or other dietary supplements. This product may be unsafe when used before surgery or other medical procedures. It is important to fully inform your doctor about the herbal, vitamins, mineral or any other supplements you are taking before any kind of surgery or medical procedure. With the exception of certain products that are generally recognized as safe in normal quantities, including use of folic acid and prenatal vitamins during pregnancy, this product has not been sufficiently studied to determine whether it is safe to use during pregnancy or nursing or by persons younger than 2 years of age.

Further information

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